Research is a core component of trauma activities. Research is important in recognizing the needs of children and adolescents, verifying the effectiveness of our interventions and evaluating our projects and programs. Members are involved in a variety of clinical research projects and have had many publications in peer-reviewed journals, such as The Journal of Trauma, Brain Injury and the Journal of Head Injury Rehabilitation. In this section, you will find results from completed projects of the Montreal Children's Hospital Trauma Programs, as well as information and updates on our current studies. It also highlights our research initiatives and collaborative work.
Research Projects
Ongoing Projects
1. Development and initial impact of a rehabilitation intervention for children and adolescents with atypical recovery following a mild traumatic brain injury
Who are the researchers?
Isabelle Gagnon, Carlo Galli, Debbie Friedman, Grant Iverson, Geneviève Cadoret, Helen Kocilowicz and Bonnie Swaine
What is the research question?
Can we provide a safe and effective rehabilitation treatment for children who are slow to recover after a mild head injury or concussion?
What are we doing?
We are using clinical expertise and scientific knowledge to refine and test a multi-level intervention for children and adolescents who fail to recover within the first few weeks after the mild head injury or concussion.
How is this project funded?
This project is funded by a research grant from the Réseau Provincial de Recherche en Réadaptation du Québec (Réseau du Fonds de la Recherche en Santé du Québec).
When will we have results?
We are expecting to present results from this study in January 2010.
2. Visual perception deficits in children after mild traumatic brain injury: psychophysics, electrophysiology and impact on postural stability
Who are the researchers?
Robert Forget, Jocelyn Faubert, Michelle McKerral, Isabelle Gagnon.
Collaborator: Debbie Friedman
What is the research question?
We want to know whether we can identify visual perception and balance problems in children and adolescents who have sustained a mild head injury or concussion
What are we doing?
We are assessing children with mild head injuries and children without head injuries over a one year period to see whether they have problems and when these problems resolve. Children are seen 3 times over the 12 month-period and every time we evaluate them using various tests focusing on the perception of visual stimuli and in a virtual reality setting to better assess their balance.
How is this project funded?
This project is funded by a research grant from the Canadian Institutes of Health Research
When will we have results?
We are expecting to present results from this study sometime in 2012.
3. Returning to physical activities after a MTBI in children and adolescents: the role of balance deficits, post-concussion symptoms and self-efficacy
Who are the researchers?
Isabelle Gagnon, Robert Forget
What is the research question?
We want to know whether we can identify balance and confidence problems in children and adolescents who have sustained a mild traumatic brain injury or concussion
What are we doing?
We are assessing children with mild traumatic brain injuries and children without head injuries over a one year period to see whether they have problems and when these problems resolve. Children are seen 4 times over the 12 month-period and every time we evaluate them using various tests focusing on their balance and confidence level when participating in physical activities.
How is this project funded?
This project is funded by a research grant from the Canadian Institutes of Health Research and the SickKids Foundation.
When will we have results?
This study is just beginning and we expect to present results from this study sometime in 2011.
4. Evaluation and Standardization of the Pediatric Test of Brain Injury
Who are the researchers?
Isabelle Gagnon, Jeff Atkinson, Gillian Hotz (Principal Investigator of multi-center study)
What is the research question?
We want to use a newly developed test of language and cognitive abilities to see whether it works well with children who have had a severe or moderate head injury
What are we doing?
We are using the test with every child or adolescent who is admitted to the Montreal Children's Hospital and sending the results of the test to the main researcher in this project (Gillian Hotz) to be analyzed.
How is this project funded?
This project requires no funds
When will we have results?
We are collecting information until the summer of 2009 and results should be available by the end of 2009.
5. Comparing the Balance Error Scoring System and the Bruninks-Oseretsky Test of Motor Proficiency balance subtest with the MTBI pediatric population
Who are the researchers?
Isabelle Gagnon, Carlo Galli, Julie Simard
What is the research question?
We wanted to know whether 2 tests we use currently in clinical practice were addressing the same aspects of balance in children and adolescents who had a mild head injury or concussion.
What are we doing?
We evaluated 22 children with the two tests and then used statistical tests to compare their performances on both.
How is this project funded?
The project requires no funding.
When will we have the results?
We have completed all the evaluations and we are presently working on analyzing the results. They should be available in January 2009.
6. Parental Survey of Booster Seat use among Canadian Children
Who are the researchers?
Isabelle Gagnon, Lisa Grilli, Beth Bruce (Principal Investigator of nationwide study)
What is the research question?
We want to know which factors influence parent's ability to use booster seats on a regular basis.
What are we doing?
We are recruiting parents of children aged 4 to 9 years of age. They will fill out a survey consisting of 15 multiple-choice questions. This will be done electronically on a laptop computer.
How is this project funded?
This project is funded by AUTO 21, a Federal Network of Centres of Excellence and from the IWK Health Centre Foundation.
When will we have the results?
Recruitment will begin in June 2009. Results should be completed by October 2009.
Completed projects in 2008
1. Physical exertion testing in the Return to sports clinic at the MCH
Who were the researchers?
Isabelle Gagnon, Carlo Galli, Debbie Friedman, Julie Simard, Helen Kocilowicz, Lisa Grilli
What was the research question?
We wanted to know whether children were truly ready to return to sports after a mild head injury or concussion, once their symptoms had resolved.
What were we doing?
We reviewed the medical files of over 100 children who had been seen in the Mild Traumatic Brain Injury/Return to Sports Clinic of the Montreal Children's Hospital. We documented whether they had successfully completed a physical test once their symptoms had resolved at rest.
How was this project funded?
A research fellow, funded by a summer student bursary from the Canadian Institutes for Health Research through the COPSE Program of the University of Montreal, performed most of the data collection activities for this project.
What are the results?
We found that a total of 24% of children and adolescents had an increase in their symptoms (headache, dizziness and fatigue) after the phsyical test and were asked to not return to their sports right away. We also found that children who had lost consciousness and those who had a history of migraines before the injury were more likely to fail the test than those without.
What does it mean for practice?
The results of this study show that, although asymptomatic at rest for at least 1 week, a significant number of children and adolescents cannot successfully begin practicing physical conditioning activities. This means that they should be monitored even after their symptoms have resolved to make sure that the return to sports is safe.
Completed projects in 2009
1. Developmental trajectory of infants and toddlers who sustained a moderate to severe TBI
Who are the researchers?
Anne Marie Hurteau, Katrine Doucet, Isabelle Jargaille, Line Parent, Isabelle Gagnon
What is the research question?
We want to know whether infants and young children (those younger than 2 years) who had severe head injuries had different trajectories of development than what we know for children without injuries.
What are we doing?
The children were seen yearly as part of their regular clinical follow-up by the Occupational Therapist, the Speech and Language Pathologist and Audiologist. We decided to review the results of the tests they had been administered up to the age of 7 years and find out whether they had persistent problems related to the head injury they had sustained as an young child.
How is this project funded?
This was a chart review by the clinicians themselves and therefore no funding was necessary to complete the study.
What are the results?
Close to 40 children met our selection criteria. In view of the little numbers of subjects no specific conclusions can be drawn from our data. Globally this group of children exhibited development milestones within the normal range. Only few of them presented difficulties in either aspects of speech and language development or in motor development. It is not possible at this time to interpret if these difficulties are directly related to the TBI.
What does it mean for practice?
We will continue following these children as part of our clinical practice. The lack of obvious consequences of early TBI might be explained by the small number of children seen, by tests that may not be sensitive enough or by the need to look at other aspects of development such as neuropsychological functioning when the children reach school age.